Performance of the crystalens hd iol
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Performance of the Crystalens HD ® IOL. Elizabeth Yeu, MD, Mariko Shirayama, MD, Quianta L. Moore, MD, Li Wang, MD, PhD, Douglas D. Koch, MD Cullen Eye Institute, Baylor College of Medicine Houston, TX. Purpose.

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Performance of the Crystalens HD ® IOL

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Performance of the Crystalens HD® IOL

Elizabeth Yeu, MD, Mariko Shirayama, MD,

Quianta L. Moore, MD, Li Wang, MD, PhD,

Douglas D. Koch, MD

Cullen Eye Institute, Baylor College of Medicine

Houston, TX


  • To evaluate the visual performance of eyes implanted with the Crystalens HD® IOL as compared to the Acrysof® SN60WF IOL.


  • Prospective, non-randomized study that evaluated otherwise healthy pseudophakic eyes implanted with either the Crystalens HD or SN60WF IOLs

  • Invited to participate POD1 after uncomplicated phaco/PCIOL

  • Only 1 eye per patient was evaluated

Methods: POM1 and POM4-6

  • Parameters:

    • Uncorrected distance visual acuity (UCDVA)

    • Best-corrected distance visual acuity (BCDVA)

    • Distance-corrected near visual acuity: 40cm (DCNVA)

    • Amount of add-power required to read 1-over threshold

    • “Push-down” test x 3

    • Accommodative amplitude (AA) determined

      • 1/”push down” distance (cm)= value in D

      • AA= “Push down” – “Add” power @40cm

    • Pupil size: Neuroptics®pupillometer

    • Humphrey Atlas corneal topography


  • Corneal image quality was assessed via the Zernike Tool program (AMO), which calculated polychromatic modulation transfer function (PMTF) with Stiles-Crawford effect

    • PMTF at 15 cpd (20/40 object)

  • PMTF of corneal HOAs (3rd to 6th order, 4-mm pupil) from corneal topographic elevation data (Humphrey Atlas) were calculated

Effect of defocus on image quality

  • Defocus from -3 D to +3 D in 0.1 D intervals were added to the HOAs of the corneas

  • Depth of focus (DOF) was defined by 2 criteria

Depth of focus: Criteria

Peak value


80% Peak


50% Peak

  • Range over which the PMTF maintains 80% of maximum PMTF value (DOF80)

    • Changes in image quality are not noticed when the MTF maintains 80% of its optimal value

  • Range over which the PMTF maintains 50% of maximum PMTF value (DOF50)

    • DOF50 overcomes the disadvantage of the DOF80, in which eyes with higher peak PMTF values tend to drop faster

    • Hence, this range captures a greater defocus DOF while maintaining decent image quality


  • POM 1:

    • 19 eyes Crystalens HD

    • 29 eyes SN60WF

  • POM4-6:

    • 9 Crystalens HD

    • 8 SN60WF

Results: POM 1

  • *Significantly different in AA and ** pupil size between groups (p<0.05); other comparisons p>0.05

  • No significant correlations seen between AA and pupil size

Results: POM 4-6

  • All pairs between groups (UCVA, BCDVA, DCNVA, AA and pupil size): p>0.05

  • *In SN60WF eyes, AA negatively correlated with pupil size (r= -0.84, p<0.05): Smaller pupil size strongly correlated with increased AA

DOF (D): mean ± SD (range)

  • No significant correlations between DOF and AA in all groups

  • No differences in HOAs and DOF between SN60WF and Crystalens (all P>0.05)

Crystalens HD IOL provides between an average of ~0.18 to ~0.85 D greater AA than SN60WF

No differences in corneal pseudoaccommodation account for AA

Additional AA from Crystalens HD from the IOL, but true flexing at the hinge vs. lenticularpseudoaccommodation is unclear


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